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MARY TM DICERBO PC NPI 1770703100


NPI Information

NPI: 1770703100
Provider Name: MARY TM DICERBO, PC

Doing Business As: WELLNESS FROM THE INSIDE OUT FAMILY CHIROPRACTIC

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
765 ELA RD
SUITE 105
LAKE ZURICH, IL
ZIP 60047
Phone: (847) 550-1115
Get Directions

MARY TM DICERBO, PC is a chiropractor in Lake Zurich, IL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. MARY TM DICERBO, PC NPI is 1770703100. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Wellness From The Inside Out Family Chiropractic.

The provider's business location address is:

765 ELA RD
SUITE 105
LAKE ZURICH, IL
ZIP 60047-385
Phone: (847) 550-1115
Fax: (847) 550-1117

The provider's authorized official is Mary Tm Dicerbo .
The authorized official title is Owner and has the following contact phone number (847) 550-1115.

The enumeration date for this NPI number is 4/26/2007 and was last updated on 10/12/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1212657MEDICARE PINILLINOIS
204932472OTHERILLINOISBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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